Characterising and describing postpartum haemorrhage emergency kits in context: a protocol for a mixed-methods study

IntroductionPostpartum haemorrhage (PPH) is an obstetric emergency requiring prompt and accurate response. PPH emergency kits containing equipment and medications can facilitate this kind of intervention, but their design and contents vary, potentially introducing risk of confusion or delay. Designs may be suboptimal, and relying on localised kit contents may result in supply chain costs, increased waste and missed opportunities for economies of scale. This study aims to characterise contextual influences on current practice in relation to PPH kits and to describe the range of kits currently employed in UK maternity units.Methods and analysisThis mixed-methods study comprises two phases. The first will use field observations and semistructured interviews to research PPH kits in a small number (3–5) of maternity units that will be selected to represent diversity. Analysis will be conducted both using an established human factors and ergonomics framework and using the constant comparative method for qualitative data analysis. The second phase will use a research and development platform (Thiscovery) to conduct a crowdsourced photography-based audit of PPH kits currently in use in the UK. Participants will tag images to indicate which objects have been photographed. Quantitative analysis will report the frequency of inclusion of each item in kits and the content differences between kit and unit types. All maternity units in the UK will be invited to take part, with additional targeted recruitment strategies used, if necessary, to ensure that the final sample includes different maternity unit types, sizes and PPH kit types. Study results will inform future work to develop consensus on effective PPH kit designs.Ethics and disseminationApproval has been received from the UK Health Research Authority (project ID 274147). Study results will be reported through the research institute’s website, presented at conferences and published in peer-reviewed journals.

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Consent for the use of human biological samples for biomedical research: a mixed methods study exploring the UK public's preferences

BMJ Open ◽

10.1136/bmjopen-2013-003022 ◽

2013 ◽

Vol 3 (8) ◽

pp. e003022 ◽

Cited By ~ 6

Author(s):

Celine Lewis ◽

Margaret Clotworthy ◽

Shona Hilton ◽

Caroline Magee ◽

Mark J Robertson ◽

...

Keyword(s):

Mixed Methods ◽

Biomedical Research ◽

Biological Samples ◽

Mixed Methods Study ◽

The Uk

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Health and Access to Healthcare in Homeless People: Protocol for a Mixed-methods Study

10.21203/rs.3.rs-880066/v1 ◽

2021 ◽

Author(s):

Miguel A. Bedmar Pérez ◽

Miquel Bennasar-Veny ◽

Berta Artigas Lelong ◽

Francisca Salvà Mut ◽

Joan Pou Bordoy ◽

...

Keyword(s):

Mixed Methods ◽

Health Status ◽

Homeless People ◽

Premature Death ◽

Access To Healthcare ◽

Mixed Methods Study ◽

Poor Health ◽

Barriers And Facilitators ◽

Second Phase ◽

Structural Factors

Abstract BackgroundHomelessness is a more complex problem than the simple lack of a place to live. Homeless people (HP) often suffer from poor health and premature death due to their limited access healthcare, and are also deprived of basic human and social rights. The study protocol described here aims to evaluate the complex relationship between homelessness and health, and identify the barriers and facilitators that impact access to healthcare by HP.MethodsThis is a mixed-methods study that uses an explanatory sequential design. The first phase will consist of a cross-sectional study of 300 HP. Specific health questionnaires will be used to obtain information on health status, challenges during the COVID-19 pandemic, self-reported use of healthcare, diagnoses and pharmacologic treatments, substance abuse (DAST-10), diet quality (IASE), depression (PHQ-9), and human basic needs and social support (SSQ-6). The second phase will be a qualitative study of HP using the “life story” technique with purposive sampling. We will determine the effects of different personal, family, and structural factors on the life and health status of participants. The interviews will be structured and defined using Nussbaum's capability approach. DiscussionIt is well-known that HP experience poor health and premature death, but more information is needed about the influence of the different specific social determinants of these outcomes and about the barriers and facilitators that affect the access of HP to healthcare. The results of this mixed methods study will help to develop global health strategies that improve the health and access to healthcare in HP.

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Seeking the balance between caregiving in dementia, family and employment: study protocol for a mixed methods study in Northern Germany

BMJ Open ◽

10.1136/bmjopen-2017-019444 ◽

2018 ◽

Vol 8 (2) ◽

pp. e019444 ◽

Cited By ~ 3

Author(s):

Lydia Neubert ◽

Hans-Helmut König ◽

Christian Brettschneider

Keyword(s):

Mixed Methods ◽

Labour Force ◽

Informal Caregivers ◽

Personal Characteristics ◽

Labour Force Participation ◽

Informal Caregiving ◽

German Society ◽

Mixed Methods Study ◽

Northern Germany ◽

Study Results

IntroductionThe debate on reconciliation between childcare and working has to be expanded to caregiving for the elderly, since the importance of informal caregiving will increase in the future due to populations’ ageing and women’s increasing labour force participation. Informal caregivers who are caring for the rising number of persons with dementia (PwD) are often female and subjected to high caregiving requirements. These are added to further demands emerging from their family and work life. How affected caregivers seek to balance those requirements depends on, inter alia, their own characteristics and the informal caregiving network to whom they relate. Both aspects were not yet considered in previous studies. This mixed methods study thus aims to explore the reconciliation between caregiving in dementia, family and employment by including different members of caregiving networks of home-dwelling PwD and by considering their personal characteristics.Methods and analysisBy purposive sampling, we include at least five caregiving networks of home-dwelling PwD; each of them consisting of at least three informal caregivers living in Northern Germany. Narrative interviews of participants will be recorded, transcribed verbatim and interpreted according to the Documentary Method (QUAL). By completing standardised questionnaires, participants will provide sociodemographic and psychographic data concerning themselves and the networks from whom they arise (quan). This supplemental, descriptive information will give further background to the themes and types emerging from the interviews. Hence, the quan-data enrich the QUAL-data by exploring the narratives of participants in the light of their personal and network-related characteristics.Ethics and disseminationEthical approval was obtained from the Ethics Committee of the German Society of Nursing Sciences. Study results will be disseminated through conference presentations and publications in peer-reviewed journals.Trial registration numberDRKS00012929.

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The impact of self-efficacy and health literacy on outcome after bariatric surgery in Sweden: a protocol for a prospective, longitudinal mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2018-027272 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027272 ◽

Cited By ~ 1

Author(s):

Maria Jaensson ◽

Karuna Dahlberg ◽

Ulrica Nilsson ◽

Erik Stenberg

Keyword(s):

Bariatric Surgery ◽

Mixed Methods ◽

Health Literacy ◽

Qualitative Study ◽

Self Efficacy ◽

Mixed Methods Study ◽

Inclusion Criteria ◽

Study Results ◽

Prospective Longitudinal ◽

The Impact

IntroductionA person-centred approach, to know about a person’s individual weaknesses and strengths, is warranted in today’s healthcare in Sweden. When a person suffers from obesity, there are not only risks for comorbidities but also increased risk for decreased health-related quality of life (HRQoL). After bariatric surgery, there are also risks for complications; however, healthcare service expects the person to have sufficient ability to handle recovery after surgery. The need is to investigate how a person’s self-efficacy and health literacy(HL) skills are important to determine their effect on recovery as well as HRQoL after bariatric surgery. It can, involve the person in the care, improve shared decision-making, and perhaps decrease complications and readmissions.Method and analysisThis is a prospective, longitudinal mixed-methods study with the intent of including 700 patients from three bariatric centres in Sweden (phase 1); 20 patients will be included in a qualitative study (phase 2). Inclusion criteria will be age >17 years, scheduled primary bariatric surgery and ability to read and understand the Swedish language in speech and in writing. Inclusion criteria for the qualitative study will be patients who reported a low self-efficacy, with a selection to ensure maximum variation regarding age and gender. Before bariatric surgery patients will answer a questionnaire including 20 items. Valid and reliable instruments will be used to investigate general self-efficacy (10 items) and functional and communicative and critical HL (10 items). This data collection will then be merged with data from the Scandinavian Obesity Surgery Registry. Analysis will be performed 30 days, 1 year and 2 years after bariatric surgery. One year after bariatric surgery the qualitative study will be performed. The main outcomes are the impact of a person’s self-efficacy and HL on recovery after bariatric surgery.Ethics and disseminationThe study has received approval from the ethical review board in Uppsala, Sweden (number 2018/256). The study results will be disseminated through peer-reviewed publications and conference presentations to the scientific community and social media.

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Missed opportunities to prevent HIV infections among pre‐exposure prophylaxis users: a population‐based mixed methods study, San Francisco, United States

Journal of the International AIDS Society ◽

10.1002/jia2.25472 ◽

2020 ◽

Vol 23 (4) ◽

Cited By ~ 5

Author(s):

Matthew A Spinelli ◽

Nicole Laborde ◽

Patrick Kinley ◽

Ryan Whitacre ◽

Hyman M Scott ◽

...

Keyword(s):

United States ◽

Mixed Methods ◽

San Francisco ◽

Hiv Infections ◽

Population Based ◽

Mixed Methods Study ◽

Missed Opportunities ◽

Exposure Prophylaxis

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Self-Reported Patterns of Use of Alcohol and Drugs After Suicide Bereavement and Other Sudden Losses: A Mixed Methods Study of 1,854 Young Bereaved Adults in the UK

Frontiers in Psychology ◽

10.3389/fpsyg.2020.01024 ◽

2020 ◽

Vol 11 ◽

Cited By ~ 1

Author(s):

Alexandra Pitman ◽

Fiona Stevenson ◽

Michael King ◽

David Osborn

Keyword(s):

Mixed Methods ◽

Mixed Methods Study ◽

Alcohol And Drugs ◽

Patterns Of Use ◽

Suicide Bereavement ◽

The Uk

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Emergency Medicine Resident Physicians’ Perceptions of Electronic Documentation and Workflow

Applied Clinical Informatics ◽

10.4338/aci-2014-08-ra-0065 ◽

2015 ◽

Vol 06 (01) ◽

pp. 27-41 ◽

Cited By ~ 18

Author(s):

P.M. Neri ◽

L. Redden ◽

S. Poole ◽

C.N. Pozner ◽

J. Horsky ◽

...

Keyword(s):

Emergency Medicine ◽

Mixed Methods ◽

Comparative Method ◽

Mixed Methods Study ◽

Standardized Patient ◽

Electronic Documentation ◽

Patient Acuity ◽

Emergency Medicine Resident ◽

Medicine Resident ◽

Resident Physicians

SummaryObjective: To understand emergency department (ED) physicians’ use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules.Methods: We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes.Results: Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources.Conclusion: We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same work-flow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to optimize efficiency, such as improving integration of clinical data. These findings should be tested quantitatively in a larger, representative study.Citation: Neri PM, Redden L, Poole S, Pozner CN, Horsky J, Raja AS, Poon E, Schiff G, Landman A. Emergency medicine resident physicians’ perceptions of electronic documentation and workflow – a mixed methods study. Appl Clin Inf 2015; 6: 27–41http://dx.doi.org/10.4338/ACI-2014-08-RA-0065

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Healthcare professionals’ attitudes of implementing a chemotherapy electronic prescribing system: A mixed methods study

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219892304 ◽

2019 ◽

Vol 26 (5) ◽

pp. 1164-1171

Author(s):

Annette (Netty) V Cracknell

Keyword(s):

Mixed Methods ◽

Healthcare Professionals ◽

Anticancer Therapy ◽

Healthcare Systems ◽

Mixed Methods Study ◽

Electronic Prescribing ◽

Second Phase ◽

System A ◽

Qualitative Exploration ◽

Published Research

Purpose Recent research has investigated the attitudes of healthcare professionals when implementing electronic healthcare systems such as electronic medical records or electronic prescribing in primary care. There is limited research on implementation of electronic prescribing in secondary care and no published research exploring implementation of systemic-anticancer therapy (includes chemotherapy, TKIs, monoclonal antibodies, etc) electronic prescribing. By considering what attitudes healthcare professionals had towards the implementation of systemic-anticancer therapy (SACT) electronic prescribing systems, recommendations could be developed and used to aid successful future implementations. Methods This mixed methods study was in three phases. The first phase was a qualitative exploration of attitudes of healthcare professionals towards the implementation of a systemic-anticancer therapy electronic prescribing system, with the development of a questionnaire based on these findings. This was followed by a quantitative second phase where the results from the questionnaire were used to assess if the qualitative results could be generalised to a larger population. Further progression in phase three looked at developing recommendations based on the factors found in order to aid future implementations for hospitals. Results Thirteen factors were found relating to attitudes of healthcare staff when implementing systemic-anticancer therapy electronic prescribing. Nine of these factors were cited by other researchers when implementing other electronic healthcare systems. Four factors appeared to be specific to systemic-anticancer therapy electronic prescribing implementations. Nineteen recommendations were proposed when implementing a systemic-anticancer therapy electronic prescribing system. Conclusion This is the first study, to our knowledge, to examine the attitudes of healthcare professionals when implementing a systemic-anticancer therapy electronic prescribing system and the first to define important factors and list recommendations to manage these.

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Does Sense make sense? Mixed methods study of a Dutch sexual health program

European Journal of Public Health ◽

10.1093/eurpub/ckz185.353 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

R Joosten ◽

L Jochems ◽

C Wijsen ◽

T Heijman ◽

A Timen

Keyword(s):

Health Care ◽

Mixed Methods ◽

Young People ◽

Sexual Health ◽

Health Care Professionals ◽

Mixed Methods Study ◽

Structured Interviews ◽

Open Atmosphere ◽

Study Results

Abstract In the Netherlands, the Sense program addresses several key elements of sexual health for young people <25 year. This program offers free consultations at the PHS concerning STI, contraceptives, pregnancy or sexuality. The performance of this program has not been studied yet. This mixed methods study investigates facilitators and barriers of a Sense consultation from the perspective of clients and health care professionals (HCP) and investigates the outcome of the consultation at three points in time. Semi-structured interviews were conducted after consultation among 16 clients and 6 HCP. Questionnaires were collected directly after consultation and at 3, 6 and 12 months after consultation. Two cohorts were recruited; clients with STI consultation only and clients with questions related to sexuality, contraception and pregnancy (Sense consultation, SC). Satisfaction of the consultation and applicability of the given advice was measured. In the follow up presence of STI, pregnancy, sexual problem and contraceptive use was measured. A minority of the interviewed clients were familiar with Sense, highly valued the expertise of the HCP and the open atmosphere during the consultation. Reasons for visiting Sense included expertise, more anonymity and feeling more comfortable than at the GP. The questionnaire after consultation was returned by 144 STI clients and 32 SC clients. Both type of consultation were highly valued and advice was easily applicable. The follow up cohort included 97 STI clients and 23 SC clients. Response rate of the 3- and 6 month-questionnaires was 61%. Results of the full one year follow-up are expected in September 2019. Study results provide evidence for a highly valued Sense program, by both clients and HCP. Sense is a platform to discuss STI, contraception and sexuality in an open atmosphere, though familiarity with Sense is low. A major conclusion is that an STI consultation provides the opportunity to address questions related to sexuality. Key messages The Sense program is highly valued by young people, and yet the program is not widely known among young people. There is need for more publicity to the program to enable more young people to use this program and to improve the sexual health care of young Dutch people.

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